BACKGROUND: Proper haemostasis is an important prerequisite for a successful outcome in all operative fields. TachoSil is used in many surgical specialties, especially for diffuse bleeding. However, TachoSil is not only used for haemostasis but also for closure of other anatomical structures. OBJECTIVE: To review the literature concerning the efficacy of TachoSil, a topical fibrin-based haemostat. METHODS: PubMed was searched for data on TachoSil and TachoComb from clinical trials and basic research. RESULTS/CONCLUSION: TachoSil is used in many surgical specialties and has proven to be a valuable tool for several indications. It also seems to be cost effective. Solid data from randomized controlled trials are available for liver surgery, thoracic surgery and urology where a positive value is clearly documented.